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Minerva Chirurgica 2012 October;67(5):381-7

language: English

Early versus delayed laparoscopic cholecystectomy for acute cholecystitis

Solej M. 1, Martino V. 1, Mao P. 1, Enrico S. 1, Rosa R. 1, Fornari M. 1, Destefano I. 1, Ferrarese A. G. 1, Gibin E. 1, Bindi F. 1, Falcone A. 1, Ala U. 2, Nano M. 1

1 Section of General Surgery, Department of Oncology, University of Turin, San Luigi Gonzaga Hospital, Orbassano, Turin, Italy;
2 Genetics, Biology and Biochemistry Department, Molecular Biotechnology Center (MBC), University of Turin, San Luigi Gonzaga Hospital, Orbassano, Turin, Italy


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AIM: Laparoscopic cholecystectomy, currently the gold standard treatment for cholelithiasis, has been extended to treating acute cholecystitis as well. However, operation timing remains controversial. The aim of this retrospective study was to compare our data on the timing of surgery for early and delayed laparoscopic cholecystectomy for acute cholecystitis.
METHODS: From January 1, 2006 to December 31, 2010, 508 laparoscopic cholecystectomy procedures were performed, 149 of which for acute cholecystitis: 122 operations were defined as early (performed within 72 hours of symptom onset) and 27 as delayed (72 hours to 9 days from symptom onset).
RESULTS: There were no statistically significant differences in operating time, conversion or complications rates between early and delayed procedures. The total length of hospital stay was longer for patients who had undergone a delayed procedure. The success rates were similar irrespective of the surgeon’s level of experience.
CONCLUSION: Patients operated on for acute cholelithiasis between 72 hours and up to 9 days after symptom onset may benefit similarly as from an earlier operation. Delayed laparoscopic cholecystectomy for acute cholelithiasis is a feasible and safe procedure that compares favorably with early laparoscopic cholecystectomy.

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mario.nano@unito.it